Abstract

Introduction

A cervical spine lesion (CSL) is
common among polytrauma patients. Injuries may be life threatening. The
clinical impact of CSL in multiple injured patients is the focus of this study.

Methods

A retrospective investigation on a
total of 62,903 patients of the Trauma Register DGU® from
2009 and 2014 was performed. Preclinical and clinical data were analyzed.

Results

The cohort depicted the typical severity
in polytrauma (mean age 51 ±21;
mean ISS of 22 ± 12). 1,321 patients sustained a CSL with an AIS 4-6 including
complete spinal cord syndrome. The number of male patients was more than
twice as high as of female patients. Leading causes for CSL were car
accidents, falls from <3m height and falls from >3m height. 12,023 patients
were unconscious (GCS ≤8).
The majority had a CSL of AIS <2. 406 unconscious patients suffered from a
CSL with an AIS 4-6. Cardiopulmonary resuscitation (CPR) was performed in 2,000
patients in the preclinical setting and 1,003 patients received CPR in the
resuscitation bay. Severe CSL (AIS 4-6) had a significantly lower blood
pressure (102mmHg ± 46) and a significantly
lower heart rate (74/min ± 34) than patients with less severe CSLs
(AIS <2). Hospitalization
was extended with the severity of CSL. Early mortality was high. More than half
of the patients with CSLs (AIS 2-6) died within the first 24 hours. 404
patients were transferred to a rehabilitation facility.

Conclusion

Cervical
spine lesions imply a peculiar element among polytrauma patients. Early
mortality correlates with the severity of CSL. Rehabilitation facilities are
mainly the end point.